Polyvagal Ladder

## **What is the polyvagal theory?** The Polyvagal Theory was developed by neuroscientist and psychologist Dr. Stephen Porges back in 1994. He posits that our brain and body work in tandem to respond to anything that stresses us out. Through this theory, he proposes that our autonomic nervous system has three main states when responding to stressors (Polyvagal Institute, 2024): - The first is mobilization, or more commonly, our fight or flight response. This response is activated when we're faced with threats or danger. It is through this response that our body prepares us to either fight the threat/face the danger, or to run away from it. - The second is immobilization, sometimes referred to as "collapse." If we're faced with something so overwhelming to the point that we feel hopeless and/or powerless, our bodies shut down. And when it shuts down, we become numb and feel disconnected. - The third is the ventral vagal state, or "social engagement." This is the state we enter when we feel safe and connected to others. We become relaxed and more social, and our face, eyes, and tone of voice will express this. All three of these autonomic nervous system states are managed by the vagus nerve, which also regulates our heart rate, breathing, digestion, immune response, and our overall emotional state.

## **What is a Polyvagal Ladder?** The Polyvagal Ladder is a concept derived from the Polyvagal Theory. It provides a framework for understanding how the autonomic nervous system responds to stress and danger, and how these responses affect our behavioral, emotional, and overall nervous system regulation. The ladder has three primary states (Reagan, 2021): - **Ventral vagal complex/state**: At the top of the ladder, when we perceive safety, the body is conducive to social engagement, growth, and restoration. This state is controlled by the myelinated branch of the vagus nerve, promoting calmness, connection, and positive social interactions. - **Sympathetic state**: A step down the ladder, when a threat is perceived and the environment doesn't feel safe, the sympathetic nervous system activates. This state prepares the body for action, forcing the person to experience a fight or flight response. - **Dorsal vagal state**: At the bottom of the ladder, when the threat is perceived as inescapable or overwhelming, the dorsal vagal complex of the parasympathetic nervous system induces a freeze response. This state is characterized by disconnection, numbness, and a sense of helplessness. ### **Principles and beliefs informing polyvagal ladders** The Polyvagal Theory introduces the concept of the Polyvagal Ladder as a metaphorical illustration of how our nervous system navigates through states of safety, danger, and life-threatening situations. Here are some key principles and beliefs that inform the concept of the Polyvagal Ladder (Khiron Clinics, 2020): - **Neuroception**: A foundational concept in Polyvagal Theory is "neuroception," which describes how our nervous systems continuously scan the environment for safety or danger cues, often outside of conscious awareness. This process informs which rung of the ladder we find ourselves on at any given moment. - **Social engagement system**: The theory emphasizes the importance of the social engagement system in regulating our physiological state. Through facial expressions, vocal tones, and other non-verbal signals, we communicate our state of safety or threat to others, and they to us, which can help to co-regulate our nervous systems towards a state of safety. - **Adaptation and survival**: The ladder metaphor underscores the adaptiveness of our physiological responses. Each level of the ladder corresponds to strategies for survival that our ancestors developed in response to threats. Understanding this can foster compassion for ourselves and others when we find ourselves in states of mobilization or immobilization. - **Pathway to healing**: Recognizing where we or others are on the polyvagal ladder can inform interventions aimed at promoting safety and social connection. This might include techniques to engage the ventral vagal system, such as deep breathing, social engagement, or gentle movement, helping to move an individual up the ladder toward a state of safety and connection.

## **Applying polyvagal theory and the Polyvagal Ladder** The Polyvagal Ladder template, grounded in Stephen Porges' Polyvagal Theory, is a powerful visual tool used by professionals in therapy, counseling, and education. Here's how professionals use it: - **Educational tool**: Professionals use the template as a visual aid to educate individuals about the neurophysiological basis of their emotions and behaviors. By illustrating how different parts of the [nervous system](https://www.carepatron.com/guides/nervous-system-regulation-techniques/) govern reactions to stress and safety, the template clarifies emotional and physical responses to trauma or stress. - **Self-awareness and reflection**: Through discussion of the ladder, individuals are encouraged to reflect on their own experiences and identify which state they find themselves in during moments of stress, perceived danger, or safety. This [self-reflection](https://www.carepatron.com/templates/self-reflection-worksheets/) fosters a deeper understanding of personal triggers and responses. - **Therapeutic conversations**: The template provides a framework for therapeutic conversations around coping strategies and resilience. Professionals guide individuals through exploring ways to navigate from a state of dysregulation (sympathetic or dorsal vagal) back to a state of regulation and safety (ventral vagal). It helps in discussing strategies for engagement, grounding, and co-regulation. - **Intervention planning**: For therapists and counselors, the template aids in formulating personalized intervention plans. By understanding an individual's typical response patterns to stress, professionals can tailor interventions (e.g., progressive muscle relaxation, lowering blood pressure, Safe and Sound Protocol, calming techniques, somatic experiencing, trauma-informed care, etc.) that specifically address the movement up or down the ladder, aiming to enhance the capacity for staying in or returning to the ventral vagal state. - **Communication and relationship building**: In educational settings or workshops, the template facilitates discussions about emotional regulation, communication, and building healthy relationships. It helps individuals understand how their nervous system arousal affects interactions with others and offers strategies for maintaining a sense of safety and connection in relationships. - **Normalizing responses to stress**: By visualizing the commonality of these nervous system states across individuals, the template helps normalize the wide range of human responses to stress and trauma. This normalization can reduce stigma and shame associated with certain reactions, fostering a more compassionate self-view and understanding of others. ### **What is the goal of introducing this to people?** Introducing the Polyvagal Ladder aims to empower individuals with a nuanced understanding of what controls their stress and trauma responses, providing them with strategies for emotional and physiological regulation. This framework promotes resilience, emotional regulation, and enhanced social connection by facilitating a deeper connection between individuals and their bodily responses to stress (Rising Tides Counselling Services, 2025). Furthermore, applying this model in therapy fosters a collaborative relationship between therapists and clients, enabling personalized therapeutic interventions. The overarching goal is to enhance mental health and well-being by fostering safety, connectedness, and joy, highlighting the importance of the mind-body connection and social relationships in recovery and healing. Taking advantage of this concept can help those who often feel anxious, those stressed out by trauma, and other forms of distressing situations and triggers. Understanding the physiological basis of emotional states allows individuals to recognize early signs of stress or dysregulation. This awareness facilitates more effective management and regulation of emotions, reducing instances of overwhelming anxiety or panic. By identifying personal triggers and learning strategies to navigate through different states of the Polyvagal Ladder, individuals can develop a stronger resilience to stress. This resilience enables them to face challenges with greater calm and less physiological disruption. This can also be used for healing trauma. For those who have experienced trauma, the Polyvagal Ladder provides a framework for understanding their often intense and confusing physiological responses. It offers a pathway towards healing by promoting the re-establishment of safety and trust within the body. Learning to navigate the Polyvagal Ladder empowers individuals with the tools and knowledge to influence their physiological and emotional states actively. This sense of control is especially beneficial for individuals who have felt powerless over their emotional responses.

## **How does our Polyvagal Ladder template work?** Our Polyvagal Ladder template visually represents how the human body responds to stress. It functions as an educational tool, providing a straightforward way to grasp the complex dynamics of the Polyvagal Theory. It also encourages users to reflect on their experiences and stress responses by identifying with the depicted states. Visualizing the nervous system and brain's reactions as positions on a ladder simplifies understanding the transitions between states. It helps recognize each state's symptoms and triggers and contemplate strategies to return to safety and social engagement. It is important to note that the Polyvagal Theory is a model, not an exact replica or representation of the autonomic nervous system. There may be other ways of understanding and explaining the nervous system's role in emotion and behavior. Eventually, it is up to a person to choose which metaphor they use to explain and understand different nervous system states. ### **Step 1: Download a copy** To obtain a copy of our PDF file, just click on "Use template" or "Download." It's up to you if you want to print it out or stick with a digital copy. ### **Step 2: Hand a copy to your patient/client** After handing a copy of the Polyvagal Ladder to your patient, have them identify where they believe they are on the ladder. The template simply shows the polyvagal ladder, with specific feelings segregated by the three primary states. Once they pick the step on the ladder they're on, have them discuss why they feel that way. Make sure to make them feel comfortable and safe enough to share why. It's also important to do this because this is one of the ways you'll need to rely on to get to the bottom of things and determine what goes into a comprehensive examination you'll conduct, and what treatments/interventions need to be provided.

## **Common methods of managing stress** If you're handling patients/clients dealing with stress, here are some of the most common methods you can teach them so they can learn how to regulate their responses to stress: - **Deep breathing**: Deep breathing is known for its relaxing benefits. Deep breathing exercises can help regulate the nervous system and encourage the brain to relax the body. Such techniques can lower blood pressure, reduce the levels of stress hormones in the bloodstream, increase physical energy, and provide other health benefits (Department of Health & Human Services, 2015). - **Taking a walk or a hike**: Taking a walk is known to help people relax because, sometimes, having a change of scenery can help clear one's mind. You can tell them to take short walks around the neighborhood, the office, the city, or even in nature. It's one of the simplest ways to relieve stress (Matzer et al., 2017). - **Leisure activities**: Indulging one's hobbies can help people take the load off. Whether it's sports, playing video games, going on hikes, exercising, or pretty much anything that one would consider to be leisure, people can relieve stress by doing the things they love doing the most, especially if they haven't been doing them for a while because of responsibilities or personal problems (Fancourt et al., 2021). - **Yoga**: Yoga is a culmination of various relaxation techniques because it involves movement, meditation, exercise, and controlled breathing methods in one. It can boost immunity, brain function, improve muscles, increase bone density, regulate pulse, and improve sleep (Khajuria et al., 2023).

## **References** Department of Health & Human Services. (2015, September 30). Breathing to reduce stress. Better Health. https://www.betterhealth.vic.gov.au/health/healthyliving/breathing-to-reduce-stress Fancourt, D., Aughterson, H., Finn, S., Walker, E., & Steptoe, A. (2021). How leisure activities affect health: A narrative review and multi-level theoretical framework of mechanisms of action. The Lancet Psychiatry, 8(4), 329–339. https://doi.org/10.1016/s2215-0366(20)30384-9 Khajuria, A., Kumar, A., Joshi, D., & Kumaran, S. S. (2023). Reducing stress with yoga: A systematic review based on multimodal biosignals. International Journal of Yoga, 16(3), 156–170. https://doi.org/10.4103/ijoy.ijoy_218_23 Khiron Clinics. (2020, July 17). Polyvagal theory: A ladder of nervous states. https://khironclinics.com/blog/polyvagal-theory-a-ladder-of-nervous-states/ Matzer, F., Nagele, E., Lerch, N., Vajda, C., & Fazekas, C. (2017). Combining walking and relaxation for stress reduction: A randomized cross-over trial in healthy adults. Stress and Health, 34(2), 266–277. https://doi.org/10.1002/smi.2781 Reagan, L. (2021, December 30). Understanding the polyvagal ladder: A brief overview. Trauma Therapist Network. https://traumatherapistnetwork.com/understanding-the-polyvagal-ladder-a-brief-overview/ Rising Tides Counselling Services. (2025). Polyvagal theory. https://risingtidesnb.com/trauma-therapy/polyvagal-theory/ Polyvagal Institute. (2024). What is polyvagal theory? https://www.polyvagalinstitute.org/whatispolyvagaltheory